05D2100470 CLIA NUMBER - STEPHEN K LIU MD

Laboratory Demographics

  • CLIA Code: 05D2100470
  • Facility Name: STEPHEN K LIU MD
  • Facility Address: 1552 COFFEE RD STE 201
    MODESTO, CA
    ZIP 95355
  • Facility Phone: 209 524-2333
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHEN K. LIU
  • NPI Number: 1306889860
  • Taxonomy: 2085R0204X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 05D2100470
LAB Type Physician Office
Facility Name STEPHEN K LIU MD
Street 1552 COFFEE RD STE 201
City MODESTO
State CA
ZIP 95355
Phone 209 524-2333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2023
Certificate Expiration Date 8/13/2025
Facility Type Physician Office
Lab Director STEPHEN K. LIU

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This page was last updated on: 3/20/2025